1922
DOI: 10.3181/00379727-19-170
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The bile factor in pancreatitis

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Cited by 9 publications
(10 citation statements)
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“…2 9 This 'common channel theory' has found many followers despite a number of findings that are incompatible with its assumptions. One of the opposing arguments is based on the finding that pressure in the pancreatic duct exceeds biliary pressure, so that reflux into the biliary tract rather than into the pancreatic duct would occur in a common channel situation.3 4 Moreover, few patients with gall stone induced pancreatitis do in fact present with an impacted gall stone lodged at the papilla at the time of hospital admission.10 1 Even if a stone was situated within the sphincter, the terminal conduit into which the pancreatic duct and the common bile duct merge is often too short to allow for a common channel situation when an impacted stone is present. '2 In about half the general population no common conduit is present at all, and in one fifth the pancreatic duct and the bile duct drain through a separate orifice into the duodenum.…”
Section: Discussionmentioning
confidence: 99%
“…2 9 This 'common channel theory' has found many followers despite a number of findings that are incompatible with its assumptions. One of the opposing arguments is based on the finding that pressure in the pancreatic duct exceeds biliary pressure, so that reflux into the biliary tract rather than into the pancreatic duct would occur in a common channel situation.3 4 Moreover, few patients with gall stone induced pancreatitis do in fact present with an impacted gall stone lodged at the papilla at the time of hospital admission.10 1 Even if a stone was situated within the sphincter, the terminal conduit into which the pancreatic duct and the common bile duct merge is often too short to allow for a common channel situation when an impacted stone is present. '2 In about half the general population no common conduit is present at all, and in one fifth the pancreatic duct and the bile duct drain through a separate orifice into the duodenum.…”
Section: Discussionmentioning
confidence: 99%
“… 43 This proposed disease mechanism remained popular despite a number of clinical inconsistencies such as the fact that in most human beings the communication between the pancreatic duct and the common bile duct is much too short (<6 mm) to permit biliary reflux into the pancreatic duct, and that an impacted gallstone most likely would obstruct both the common bile duct and the pancreatic duct. 44 , 45 Even in the event of an existing anatomic communication, pancreatic secretory pressure still would exceed biliary pressure and pancreatic juice would flow into the bile duct rather than bile into the pancreatic duct. 46 , 47 In the context of this question, an animal model has helped greatly in elucidating the underlying disease mechanism.…”
Section: Animal Models Of Clinical Acute Pancreatitismentioning
confidence: 99%
“…In general, these experiments suggest that bile passage through the pancreas is not harmful in animals with an unobstructed duct system. (3, 39) Even with obstructed and freely communicating pancreaticbiliary systems in the goat (17), cat (113,184), and dog (3, 113), the major injury is usually to the hepatobiliary t r e e rather than to the pancreas. This has led to a search for other factors in addition to the common channel.…”
Section: Acute Pancreatitismentioning
confidence: 99%